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Updated: Sep 10, 2025
Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Adult Hospitalized Mycoplasma Cases in a Tertiary Hospital in Japan
1Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Hidaka, Japan.
Background:
Mycoplasma infections have increased globally, including in Japan. Severe pneumonia due to Mycoplasma pneumoniae (M. pneumoniae) that is resistant to macrolides has been reported in the post-COVID-19 period, but its pathogenesis and detailed treatment regimens are still unclear.
Case Series:
Four adult cases of M. pneumoniae pneumonia that required admission to the hospital in the 2024-2025 season are presented. Case 1: a 17-year-old male without a specific medical history who was admitted with pneumonia with a severe dry cough. Mycoplasma. pneumoniae genes were detected by multiplex PCR from his sputum. The patient's condition improved with minocycline and corticosteroids for 5 days. Case 2: a 88-year-old man with acute kidney injury who was admitted with severe respiratory failure. Mycoplasma antigen was detected in his pharyngeal swab. He received lascufloxacin drip infusion with corticosteroids for 10 days, and soon improved. Case 3: a 38-year-old woman with maxillary carcinoma and a history of aplastic anemia who was admitted with a severe cough. Mycoplasma antigen was detected in her pharyngeal swab. She received minocycline and corticosteroid drip infusion for 1 week, and finally improved. Case 4: a 74-year-old man with multiple systemic atrophies who was admitted with a severe cough and dyspnea. Mycoplasma antigen was detected from his pharyngeal swab and methicillin-susceptible Staphylococcus aureus (MSSA) was isolated from his sputum. The patient was diagnosed with co-infection with mycoplasma and MSSA. He was treated with sulbactam/ampicillin drip infusion and oral administration of minocycline for 2 weeks, and improved.
Conclusion:
All hospitalized adult patients with mycoplasma pneumonia were treated with antibiotics, such as minocycline and fluoroquinolone, along with corticosteroid co-administration, and all of them ultimately improved, although the chest X-ray findings varied. Antibiotics other than macrolides and corticosteroids may be an effective regimen for the treatment of severe mycoplasma pneumonia with potential macrolide resistance.
Insights
Severe Mycoplasma pneumoniae pneumonia, often macrolide-resistant, requires alternative treatments. Minocycline and fluoroquinolones combined with corticosteroids show effectiveness in adult cases.
Area of Science:
- Infectious Diseases
- Pulmonology
- Microbiology
Background:
- Global increase in Mycoplasma infections, particularly Mycoplasma pneumoniae.
- Emergence of macrolide-resistant M. pneumoniae pneumonia post-COVID-19.
- Unclear pathogenesis and treatment for severe M. pneumoniae pneumonia.
Observation:
- Four adult cases of severe M. pneumoniae pneumonia requiring hospitalization during the 2024-2025 season.
- Patients presented with severe cough, respiratory failure, and dyspnea.
- Co-infection with methicillin-susceptible Staphylococcus aureus was noted in one case.
Findings:
- Successful treatment outcomes with minocycline or fluoroquinolones combined with corticosteroids.
- Treatment durations varied from 5 days to 2 weeks.
- All patients demonstrated clinical improvement, despite varied chest X-ray findings.
Implications:
- Minocycline and fluoroquinolones represent effective alternatives for macrolide-resistant M. pneumoniae pneumonia.
- Corticosteroid co-administration appears beneficial in managing severe cases.
- Further research into optimal treatment regimens for resistant M. pneumoniae is warranted.
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